EMDR Basics-Chicago EMDR Therapist Answers: What is EMDR Therapy and How Does EMDR Work?
What is EMDR Therapy?
Eye Movement Desensitization and Reprocessing (EMDR) therapy is an evidence-based therapy treatment approach developed by Dr. Francine Shapiro in the late 1980s. It is used to help people change unwanted behavior patterns, or move past experiences that continue to cause them distress.
In many ways, the goals of EMDR therapy may be the same as the goals of other therapy approaches such as cognitive behavior therapy (CBT) or “talk” therapies like psychoanalysis, but the way that EMDR strives to achieve these goals is different.
EMDR Therapy vs Talk Therapy
In addition to language-based exploration of experiences, EMDR focuses on neurological connections in the brain, as well as sensations in the physical body to support healing, As a result, EMDR is less dependent on talking as the primary or exclusive way of processing thoughts or experiences in therapy.
The decreased reliance on talking and language as the primary ways of moving through healing in EMDR therapy is important for a number of reasons. For one, people may not always have the words to describe why they may feel or react the way they do. They may not fully understand their experiences or responses, which can make them hard to talk about.
An individual may not be able to recall an event or interaction that would fully explain their feelings or behaviors, so they are at a loss to put words to the reactions that they have and that they hope to change. Additionally, sometimes people can recall the events or experiences that relate to their strong emotional, physical, or behavioral reactions, but they struggle to talk about them or become overwhelmed or retraumatized by the experience of discussing them, or by being exposed to things that remind them of these experiences.
Logic and Emotion
On the other hand, sometimes the logical part of the brain provides insight and allows someone to be able to talk very eloquently and at great length about why they think or feel the way that they do and why they should feel or respond differently to a problematic situation. They may have engaged in lengthy discussions with themselves or others about the changes that they want to make and they may even have arrived at a better understanding of their past experiences.
Despite this logic and understanding that they can articulate when faced with a situation that is activating, their emotions rush in and they have an unwanted response anyway. It’s as though they can talk through the logic without a problem when they are not in an activating situation, but when confronted in the moment, their logic and their emotions can’t talk to each other. Their emotional or physiological reactions take over, even if they logically understand that they shouldn’t, and they do not want them to. Notably, the areas of the brain that process language and that approach things logically are both found in the left hemisphere of the brain. Emotions, on the other hand, are processed in the right hemisphere. When emotions are heightened, language and logic are both suppressed.
This is not to say that talking in therapy cannot be a helpful way to gain insights into behaviors or an understanding of past experiences. Likewise, therapy focused on building skills to challenge unhelpful thoughts or to better understand or manage emotions and behaviors can be useful, especially to help cope with overwhelming situations. EMDR’s goal however is to engage the whole brain to support healing in the brain and body so that the unhelpful thoughts and overwhelming emotions or physical reactions are quieted or silenced completely rather than simply managed more effectively over time through tools or techniques. Additionally, EMDR strives to help process and heal distress in a supportive way that does not overwhelm the person with discomfort. By working directly with the neurological connections in the brain rather than requiring language processing to translate these connections into words, EMDR can move connections and healing along at a faster pace than talk-focused therapies, and without overwhelming the individual with discomfort in the process.
How Does EMDR Therapy Work?
As we go through our typical day-to-day experiences, our brain and body take in a tremendous amount of information: sensations; things that we learned; experiences; emotions; thoughts. Our brain processes through all of this input, making sense of it, putting it in context with our other knowledge and experiences, and filing it away.
When a person experiences an event or series of events that are highly emotionally activating, it can be too much for their brain and body to sort out everything that is happening; make sense of it all; and file it away in the memory stores as something challenging that happened in the past. Instead, when the body or mind get overwhelmed by an event or experience, they cannot effectively use logic to process through and make sense of all of the emotions and physical sensations. It is like the events do not get fully digested.
These unprocessed experiences get “stuck” in the brain and body, sensitive and ready to be reactivated when something happens that reminds them in some way of this unprocessed event. When the event is activated, the person may respond by experiencing some of the emotions or exhibiting some of the reactions that they had, or wished that they could have had, when this event first occurred because the body and brain are still trying to work through it all. It is as though the brain is confused and thinks that the old experience is happening in the same way all over again, even though it really isn’t. Until the experience can be fully processed, it is just sitting there, waiting to be re-activated. Only once the experience can be fully processed by the brain, can it settle within the whole brain and body system. Once this occurs, you may still remember the experience as tragic, sad, difficult, scary, or uncomfortable, but you are no longer overwhelmed by, or reacting to these feelings in the present. You are able to correctly and effectively move the experience into the brain file of “things that happened,” and out of the file “things that are happening.”
Think of it like eating a meal that didn’t sit right with you. Maybe it was heavy or greasy or something that you ate just didn’t agree with your system. While the food remains in your belly waiting to be digested, your body may feel sick or sluggish. You may experience pain or discomfort. You may feel sweaty or nauseated. Your stomach may gurgle as your body works to move the food out. You might be upset at yourself for having eaten the food, or blame whoever prepared it. You feel awful. Poking your belly, trying to move vigorously, or eating more food in this state will likely make you feel worse or be impossible to do. You may have a clear understanding of why your body is feeling the way that it does, but that knowledge alone does not make the feelings or sensations stop as long as the food still remains in your system.
After your body has completed the digestion process, you feel better. When you think about the meal, you can still remember that it was unpleasant and that you didn’t feel well, but you are no longer experiencing the same feelings and sensations in real-time and with the same level of intensity or impact.
EMDR Therapy and How it Helps
EMDR seeks to help complete the digestion process and reduce the intensity of response for experiences and events that are stuck in the brain and body system and that make you feel awful when they get activated. EMDR therapists guide the person through 8 phases of treatment to gently bring an experience, emotion, thought, or sensation back into consciousness so that it can be worked with. The therapist then uses stimulation involving both sides of the body, and thus both hemispheres of the brain to engage the logical and emotional sides of the brain. By engaging both sides of the brain with stimuli in the present, and encouraging the brain to move through existing neurological connections with the support of logic and emotion, both hemispheres work together to help complete the processing of past events or experiences. Additionally, these stimuli also require dual attention; forcing the individual to focus some of their attention on the past experience while also maintaining some of their focus in the present moment.
The bilateral stimulation (BLS,) or stimulation to both sides of the brain, and the dual attention stimuli (DAS) often take the form of guided eye movements. BLS and dual attention stimuli can also be done through tapping, music or other sounds, walking, marching, or other movements that engage both sides of the body and the brain. Following a brief period of processing time, the BLS/DAS is paused and the therapist encourages the person to reflect on what they noticed during processing or what may have shifted in their physical or emotional responses, or their thoughts relating to the experience. Care is taken by the therapist to monitor the person’s progress and support pacing so that the processing is manageable and complete without being overwhelming. This pattern of guided processing and checking in continues until connecting with the memory no longer activates intense emotions, body reactions, or negative beliefs; and instead activates adaptive beliefs.
Insights into the exact mechanisms that support the effectiveness of EMDR continue to be enhanced by ongoing research and brain imaging (1). Explorations into the roles of mechanisms such as bilateral stimulation, dual attention, working memory, relaxation, neural integration, and interhemispheric connectivity continue to lend additional insight into our collective understanding of just EMDR works. For more information about who may benefit from EMDR therapy and answers to some common EMDR myths, read this article.
Find EMDR Therapy Chicago North Shore or Virtual EMDR Therapy Online for Anxiety, PTSD, Burnout, Stress, and More
If you are curious about whether EMDR may be a good treatment approach to address your needs, contact me for a free 15-minute phone consultation. I use EMDR in my work every day at Shore Therapy and have seen significant benefits following EMDR therapy with hundreds of people, including extensive EMDR therapy online. I would be happy to answer your questions about EMDR and how I use EMDR in therapy work to treat post-traumatic stress disorder (PTSD); stress; anxiety; phobias; parenting challenges; special needs parent burnout and caregiver burnout; childhood traumas; fertility, prenatal, and birth trauma; trauma from the marginalization of LGBTQIA+ and neurodivergent folx, and in many other applications. As a PSYPACT psychologist, I can provide therapy online to people in over 35 states across the US. If I am not the right fit for your EMDR therapy needs, I am happy to point you in the direction of resources that may be helpful to you.
(1) Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers. Retrieved September 25, 2022, from https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01395/full
